Pneumothorax : a historical, clinical and experimental study.

  • Emerson, Charles Phillips, 1872-1938.
Date:
1903
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Licence: Public Domain Mark

Credit: Pneumothorax : a historical, clinical and experimental study. Source: Wellcome Collection.

Provider: This material has been provided by the Harvey Cushing/John Hay Whitney Medical Library at Yale University, through the Medical Heritage Library. The original may be consulted at the Harvey Cushing/John Hay Whitney Medical Library at Yale University.

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    tences in parentheses are our comments on the same. Paragraphs in coarser type are remarks on the article as a whole. Older Writers. The first sign of pneumothorax which we find on record is the splashing sound produced by succussion, mentioned in The Complete Works of Hippocrates. This sign is often referred to as Hippo- cratic Succussion/' yet it is well to remember that the succussion is not the sound but the shaking which produces it. This sign is re- ferred to in the above mentioned works several times. It was sup- posed to be a sure sign of empyema. Yet none of these references are in those books which critics are willing to admit belong to the genuine works of Hippocrates. 1. Hippocrates, oth Century, B. C. Littre's translation—CEuvres com- putes d'Hippocrate, 1844-1851. Vol. VII, The Diseases, p. 71. After giving the picture of a very ill person the author says, Seat him on a seat which will not stir. Let some one hold him by the arms while you shake him by the shoulders, and listen to hear on which side the sound is produced. He advises to operate on that side, but states there is less danger to incise the left. P. 67. Succussion is here recommended not for diagnostic purposes but as a therapeutic measure, in fact as one of the gentler, less heroic means to be first tried, to encourage the rupture of a peripneumonic abscess. (One cannot wonder that later writers condemned all succussion as too severe.) P. 153. The description here is of an abscess of the lung breaking into the pleura. The patient seems at first to recover since the pus occupies a larger cavity, but this soon becomes filled and the symptoms are then worse. The advice given is to aid expectoration in hopes of thus evacu- ating the pus. This failing, by succussion determine which is the affected side, and open this by incision or cautery. Vol. VI, p. 165. One does succussion, and the wave of pus strikes the wall of the chest: this patient cauterize or incise . . . P. 171. In effusion of the abdomen the diagnosis is more difficult since one can not assure himself of it by succussion. (The above five quotations are from the books on The Diseases which Almost all modern authors . . . concur in rejecting as spurious [Adams]. Hence Hippocrates is denied their authorship.) Vol. VI, p. 307. The Places in Man. The author is speaking of empyema following ruptures and contusions of the flesh, and says, If one tries succussion there is produced a wave and a sound; it is there that one should cauterize.